Healthcare Provider Details

I. General information

NPI: 1528197647
Provider Name (Legal Business Name): BIPIN L PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 05/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9990 COUNTY FARM RD SUITE - 1
RIVERSIDE CA
92503-3542
US

IV. Provider business mailing address

9990 COUNTY FARM RD SUITE - 1
RIVERSIDE CA
92503-3542
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-4741
  • Fax: 951-358-7701
Mailing address:
  • Phone: 951-358-4741
  • Fax: 951-358-7701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA46654
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: